Papillomatosis may involve the airway, most often in children. A difficult airway can develop if there is extensive laryngeal involvement.
Factors impacting the airway:
(1) extent of pre-existing conditions that may contribute to a difficult airway
(2) severity of laryngeal papillomatosis
(3) urgency of the clinical situation
In addition, pneumonia or other pre-existing cardiopulmonary disease may impact the patient's oxygen saturation, increasing the risk of hypoxia in the event of an airway emergency.
Removal of intraluminal papillomas may partially relieve the airway.
Inhalation induction in a patient with partial airway obstruction can quickly progress to complete airway obstruction.
Some anesthesiologists have used a double lumen central venous catheter to manage the airway, providing sufficient ventilation of the patient.
Close monitoring is essential, including into the post-extubation period.
Resources for emergency airway management should be readily available when managing these patients.
